Not very long ago i added ALA to my supplements, i only purchased the older type of ALA [not the stronger R - lipioc], i started on the one capsule of 600mg a day with no problems and have found great benefits in energy and the little burning i get on vary rare occasions has completely disappeared.

However, after a few weeks i tried to increase my dosage to 1200 mg a day and broke out in a awful very itchy red rash with the actual skin was peeling in the affected area, so i give it a rest for a while and the rash disappeared, went back to the original dosage and everything was fine again, i tried a second time and the same deal happened.

I am very happy with what it has done for me and i know i should be content but i can't understand why this happens, most of us know that it has been used in Europe for decades for Diabetic PN in much larger dosages than i can handle, but i can't seem to find any answers to why this happens, so any advise would be very much appreciated.
thanks
Brian

Here is a good monograph on ALA:

http://lpi.oregonstate.edu/infocente.../la/index.html

Skin rashes and hives are listed.
Once hives start, I'd be very careful with ALA. I'd stop it entirely for 2 wks and reintroduce at the lower dose.

But it might be better to switch to the R-version. I am only using 100mg a day of that, and so far no rashes.

It might be a reaction to something in the product you are using..some filler, or something that is left over during synthesis. The racemic version you use has both R and L in it, and of course that being a mixture, one doesn't know which may be causing the reaction.

I did find thiotic acid listed along with other sulfur containing compounds:
NAC listed in that list also causes rashes as a reaction.
http://www.itmonline.org/arts/sulfa.htm

It is possible that taking large doses, leaves some ALA unbound to proteins, and the unbound form is irritating, or causes a histamine release.

But once a person gets hives, you have to stop the offending thing.
Ignoring an allergic reaction, can lead to anaphylaxsis.

If you decide to reintroduce it, be very careful, and have Benadryl handy.
Please be careful.

What's a good, reputable brand for the R-version? And of course, one that won't break the bank.

The first ones I bought were Source Naturals. They were handy because I found
that 100mg was a bit much at first, so these were tablets and you could break them. But the 100mg size is big and a bit uncomfortable to swallow. After about two weeks, I increased to 100mg first thing in the morning.(no longer needing the 50mg size)

So I bought Country Life this time around. This is a small white capsule and the packaging is brown glass and more pharmaceutically presented.

It is not really expensive... at one a day it works out to about $7.50 a month.
It is much less expensive than the alpha lipoic I tried years ago. That didn't do anything for me. Like Brian, I like the energy it gives...must be sensitizing insulin. I have read some links where they are using it in studies for PCOS as well (which I had when I was younger).

can be due to a true allergic reaction...this is when antibodies attach to proteins and release histamine. Typically this is dramatic and often involves asthma, wheezing, and swelling of the throat if extreme (some seafood allergies do this, as well as peanuts, and penicillin).

But some drugs cause itching in another way as well, and it is not as life
threatening. Opiates cause histamine release by another mechanism, and this is not a true allergy. This reaction to ALA and NAC may be more like niacin...in that it stimulates histamine release without antibodies.
Many foods do this too... like tomato sauces.

So it is hard to say what is going on here with you, Brian. But one should always be careful. I don't think a doctor would be able to answer you exactly either. Perhaps an allergist would be the best to consult. But a general doctor would not know.

One of my daughter's has PCOS pretty badly. We're afraid to go the birth control pill route because another daughter of mine (a yr older than first mentioned daughter) was on the pill for PCOS (not as bad as first D) at age 17 and had a blood clot in her lung. That's good news and I'll have to see what other info I can find about that.

7.50 a month I can handle. Thanks for that.

Thank you very much Mrs D.... i did discontinue it as soon as the rash appeared and it took a while for it to heal properly again, then after 10 days i started to take the original dose of 600 mg and had no problems what so ever and the broken skin continued to heal, i have not got many of ALA capsules left, so next time i will try the R lipioc instead and i will be very careful.
thanks so much for your reply.

Brian

To add to this thread:
Brian, I had exactly the same reaction while using R-ALA (the brand was AST Sports Science). I had been using Life Extension brand and built up to 900mg/day, but that led to stomach pain - an ulcer like feeling. I thought maybe it was the brand, so I switched to the AST and started with 200mg -- gradually increased to 400mg (in all cases taking it on a full stomach to avoid stomach irritation, some would argue this also prevents absorbtion). But I was seeing some benefit. When I increased to 600mg (3x200), I was fine for a week or two, then began developing the rash you describe, very red, peeling skin in the area effected. I stopped the R-ALA for a day or two and the rash backed off. Took one 200 mg capsule and the rash reflamed for a day or two. Have stopped it completely and the rash is subsiding fairly quickly. May do a retry of the R-ALA in a few weeks at a low dose.

I have had similar rash like reactions to other meds used for PN, such as neurontin, cymbalta, etc. -- and consequently haven't been able to use them. My last blood test showed a deficiency in vitamin D, so I'm taking that now as well.